Objective: The objective of this study is to propose a novel methodology for intracranial pressure (ICP) waveform subpeak identification by incorporating arterial blood pressure (ABP) and electrocardiogram (ECG) signals from patients who have undergone traumatic brain injury (TBI).
Methods: This approach consisted of 1) multimodal signal pre-processing and initial manual ICP waveform morphology labeling, 2) semi-supervised training of a support vector machine (SVM) ICP waveform morphological classifier, and 3) a dynamic time warping barycenter averaging (DBA) based ICP waveform template generation and derivative dynamic time warping (DDTW)-driven ICP waveform subpeak mapping from template to incoming processed waveforms.
Results: This proposed framework was evaluated on 30,000 ICP waveforms and resulted in an overall subpeak identification accuracy score of 98.2%.
Conclusion: The results showcased an improvement over existing methodologies and showed resilience to variations in ICP waveform morphologies from patient to patient due to the incorporation of a subject matter expert (SME) to accommodate new and unseen ICP morphologies.
Significance: The robustness of this comprehensive approach enabled the analysis of ICP morphological features over time to provide clinicians with crucial insights regarding the development of secondary pathologies in patients and facilitate monitoring their physiological state.
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Evolving concepts in intracranial pressure monitoring - from traditional monitoring to precision medicine.
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Division of Neurosciences Critical Care, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:
A wide range of acute brain injuries, including both traumatic and non-traumatic causes, can result in elevated intracranial pressure (ICP), which in turn can cause further secondary injury to the brain, initiating a vicious cascade of propagating injury. Elevated ICP is therefore a neurological injury that requires intensive monitoring and time-sensitive interventions. Patients at high risk for developing elevated ICP undergo placement of invasive ICP monitors including external ventricular drains, intraparenchymal ICP monitors, and lumbar drains.
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Health Telematics Science Institute, Kaunas University of Technology, K. Donelaicio street 73, Kaunas LT-44249, Lithuania.
Intracranial pressure (ICP) monitoring is crucial in the management of traumatic brain injury (TBI) and other neurological conditions. Elevated ICP or too low intracranial compliance (ICC) can compromise brain perfusion. Simultaneous monitoring of ICP and ICC is needed to optimize patient-specific brain perfusion in pathological conditions.
View Article and Find Full Text PDFObjective: The objective of this study is to propose a novel methodology for intracranial pressure (ICP) waveform subpeak identification by incorporating arterial blood pressure (ABP) and electrocardiogram (ECG) signals from patients who have undergone traumatic brain injury (TBI).
Methods: This approach consisted of 1) multimodal signal pre-processing and initial manual ICP waveform morphology labeling, 2) semi-supervised training of a support vector machine (SVM) ICP waveform morphological classifier, and 3) a dynamic time warping barycenter averaging (DBA) based ICP waveform template generation and derivative dynamic time warping (DDTW)-driven ICP waveform subpeak mapping from template to incoming processed waveforms.
Results: This proposed framework was evaluated on 30,000 ICP waveforms and resulted in an overall subpeak identification accuracy score of 98.
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